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    Народът срещу Д- р Конрад Мъри - 24. 10. 2011 - Ден 16

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    andeli
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    Народът срещу Д- р Конрад Мъри - 24. 10. 2011 - Ден 16

    Писане by andeli on Пет Окт 28, 2011 5:06 pm

    Morning Session

    Dr Shafer Testimony continued


    Chernoff Cross

    Chernoff asks if one of the dangers of rapid bolus injection of Propofol is apnea. Chernoff goes over the insert of Propofol and reads that slow techniques are preferred over rapid injection to avoid apnea or hypotension.

    Chernoff goes over Dr. Shafer’s simulations. 25 mg rapid Propofol injection apnea is about 2 minutes. Defense’s simulation of 25 mg pushed over 3 to 5 minutes, there’s a low risk of apnea after 4 -5 minutes. Propofol would not be as risk after 10 minutes.

    Chernoff asks how Dr. Shafer came up with 50mg Propofol dose. Shafer says CM in his interview said he mixed propofol 1:1 with lidocaine and the syringes were 10cc. Chernoff asks if CM gave MJ 50 mg Propofol if there would be apnea after 4-5 minutes. Shafer says it’s difficult to say as he doesn’t know MJ’s pharmaceutical state.

    Chernoff shows Shafer’s 6 self injections of 50mg Propofol injections and asks if there could be indefinite number of possibilities. Shafer agrees. Shafer did self injection simulations because of Dr. White mentioned them as a hypothesis in his letter.

    Chernoff asks if Shafer is aware that there are health care providers who died because of self injection of Propofol. Shafer is aware about articles mentioning that.

    Chernoff goes back to the self injection and asks if the person is self injecting do they have to do it quick. Shafer agrees and says that they can’t do it over 3 minutes.

    Chernoff asks if Shafer’s simulations were out of thin air. Shafer says most are based on Dr. White’s letter and hypothesis of multiple injections.

    Chernoff switches to Lorazepam’s half life in stomach. It’s 22 minutes. Every 22 minutes the amount is cut in half. 8 mg swallowed 22 minutes later would be 4, another 22 minutes later it would be 2mg, another 22minutes it would be 1 mg , so in 4 hours , there would be a very low amount of free lorazepam in the stomach.

    They go over Greenblack's study. Lorazepam reaches a peak concentration in 2 hours after an oral dose. Drug goes into the stomach, and is being removed by liver and distribution in the tissues. So as long as the drugs come in the levels in blood raise, the concentration rises. When fewer drugs come in, it is removed faster than it comes in, so levels drop. Chernoff argues that even if there might be small percentage in the stomach, levels could be at peak in blood.

    Chernoff states that Dr. Shafer cannot remove the possibility that MJ woke up and swallowed Lorazepam. Shafer says he needs to know what time but it cannot be after 8AM.

    Chernoff asks questions about the urine levels of Lorazepam and Propofol. Shafer did not do examinations / calculations based on urine levels.

    Chernoff asks if urine in the bladder could be evidence for or against 100ml Propofol drip. Shafer says he doesn’t know and he needs to research and find models. For some questions Shafer says he needs information about propofol glucoronide and it wasn’t tested.

    Chernoff states that Shafer’s analysis is based on repertory arrest and he did not take into cardiac arrest. Shafer says correct.

    Chernoff mentions the comments Shafer wrote about Demerol on his report. Shafer had written MJ liked Demerol but was not addicted to it. Chernoff asks if he’s an expert in addiction , Shafer says he’s not an expert but seen examples and talked to other doctors about it.

    Chernoff asks about rapid detox. It’s when the patient is detoxing for opiates while under sedation. Chernoff asks if Shafer knows the dangers of opiates. Shafer says they are dangerous for many organs.

    Mid morning break

    Walgren redirect

    Walgren again mentions that Dr. Shafer’s work is pro bono (free of charge). Shafer says it’s his custom in these types of cases. Shafer says that he had worked for the defense and prosecution on different cases. Shafer says his position on any case is based on the science.

    Shafer also shares his research, databases and software for free online as well. Shafer wants to promote the science and even though he can earn some money for his programs he makes them available for free.

    Walgren goes over the IV lines and Shafer says he can’t say which line was used, all he knows the line had to be vented. Walgren shows People’s 157 and Excel IV line and it’s a vented line. Seacoast order shows that Murray bought 150 of those vented lines. Exel vented line is a lot smaller than the one used for demonstration.

    Walgren mentions Dr Shafer's testimony was interrupted due to a death in his family

    Walgren asks if there is anything extraordinary saying than MJ received more than 25 mg Propofol. Shafer says no and the defense is saying the same thing.

    Shafer says that he couldn’t find any scenario that support self injection and the only scenario he could find was Propofol was still running when MJ died.

    Walgren asks about Demerol. Shafer says he read Klein’s records and based on them he couldn’t say if he was an addict or not and he’s not an addiction specialist. Walgren mentions that there was no Demerol in MJ’s system.

    Shafer says he has done one scenario for the defense and if they asked he would have done more.

    Walgren mentions the new lab results about Lorazepam that shows 0.008mg of Lorazepam in MJ’s stomach which equals to 1/250th of a tablet and mentions that this is smaller than 1/43rd of a tablet mentioned by the defense.

    Shafer says he gave his opinion based on 30 years of expertise and says CM should have monitored MJ. Shafer says his opinion is not made out of thin air. It actually comes from published studies and established standards of care.

    Walgren asks if Shafer believed what CM said that MJ liked to push the drug and he was dependent on Propofol if self injection was a foreseeable risk. Shafer agrees.

    Walgren shows another Lorazepam scenario of 9 doses of IV Lorazepam 4 mg each starting at 1:30 AM. This would also explain the levels found in MJ’s blood.

    Recross by Chernoff

    Chernoff asks if the last scenario was done this weekend, because of what Chernoff said on Friday.

    Chernoff asks if 100ml IV drip Propofol was an extraordinary claim. Shafer says it’s an ordinary claim.

    Chernoff argues that Shafer is changing his testimony about the IV line used for Propofol. Shafer says that Chernoff is misstating his testimony and he only said the line had to be vented. This goes on for some time.

    Prosection rests their case.

    Defense case starts

    Donna Norris Testimony

    Direct by Gourjian

    Norris works at communications evidence unit Beverly Hills police department. She goes over the 911 call.
    12:20:18 time 911 was called
    12:20:21 begins to ring
    12:20:26 called picked up
    12:20:50 called transferred to LAFD
    12:21:03 dispatcher at police dept hangs up.
    12:21:04 911 system released the call
    Duration of the call at the police department was 46 seconds
    the call was made on June 25th 2009
    Data shows which cell tower the call came from, the part of the cell tower, cell phone provider, and a number the police can call if they need to trace back the call.

    No Cross by Walgren

    Alexander Suppal Testimony

    Gourjian Direct

    Suppal is a LAPD police surveillance specialist for 11 years.

    On June 25th he was asked to go to Carolwood to retrieve the videos. Suppal probably went around 7:30pm on June 25th. Detective Martinez was there. Security staff couldn’t play back the videos. Suppal’s first task was to find the hard drive so he had the trace the lines back to the source. Suppal finds the DVR in the basement of the house. They get a monitor and hook it up to the DVR. Suppal was with Detective Martinez and a tall African American security guard.

    They rewinded the video to the time CM and MJ came home.

    Gourjian plays a 7 minute video. It’s a camera that looks at the gate. It shows time as 00:45AM. Multiple cars arrive at 00:47AM, 00:50AM and 00:58AM. A car leaves around 01:06 Video shows security guards and fans as well.

    Gourjian shows another video. This is from a camera outside on the keypad. It shows 3 cars come in and close up of the driver’s face. It also show the fans waiting outside the street.

    Suppal did not go back to download additional footage. No one asked him to.

    No cross by Walgren

    Lunch break

    Afternoon session

    Detective Dan Myers


    Direct by Gourjian

    Martinez is an LAPD detective for 10.5 years. He went to UCLA on June 25th around 3:30PM. At UCLA they(Martinez and Smith) spoke different people. Martinez was present during half of AA's interview on June 25th. AA didn't mention putting away any vials or mention seeing a bottle in a bag.

    Martinez went to Carolwood around 7:30PM and he didn't see AA there. He saw FM. Alex Supall , surveillance specialist for the LAPD, was at Carolwood to retrieve the security footage. Martinez made the decision to only download MJ's and CM's arrival.

    Martinez was not at August 31st 2009 interview of AA but saw AA in September to take his fingerprints.

    On April , 2011 Walgren called Martinez and asked him to bring certain evidence items to his office. Walgren also told him that AA will be there. AA was parked at the police building and walked to Walgren's office with Martinez. Martinez had brough a box of evidence items but only showed the saline bag, propofol bottle and pulse oximeter to AA.

    Gourjian shows the drawings AA made on August 2009 and the saline bag he draw on April 2011 and says that they are significantly different.

    Cross by Walgren

    Walgren mentions that AA testified to the bottle in the saline bag and pulse oximeter in January.

    Walgren asks Martinez to explain the April 2011 drawing of the saline bag. Martinez says when he showed the saline bag to AA, AA said there was an additional chamber. Martinez asked him to draw it to explain.

    Redirect by Gourjian

    Gourjian says during preliminary hearing AA didn't testify that the propofol bottle was the one he saw. Walgren objects saying that at that AA hadn't seen the evidence.

    Gourjian says AA never mentioned the additional chamber on August, 2009. Martinez says he mentioned if after seeing the saline bag on April 2011.

    Martinez once again mentions that AA was only shown 3 items , saline bag, propofol bottle and pulse oximeter on April, 2011.

    Dr. Allan Metzger

    Direct by Chernoff

    Metzger met MJ 15 to 20 years ago. Metzger's relationship with MJ began professionally and later became close as friends as well. Metzger was MJ's main physician when he was in LA and he treated MJ for various things. Metzger says MJ saw other specialists as well.

    Metzger has borugh 5 page medical records with him. Metzger has seen MJ in his office on 23 June 2003. Michael had called him on 12 June 2008. At 2008 call MJ mentioned sleep issues and skin problems. Metzger gave him Tylenol PM for sleep and talked about MJ's general health and back strain. Metzger told MJ when he came to LA to see him and Klein.

    Metzger says he frequently talked with Grace about the kids.

    Metzger visited MJ at his home on April 2009. Metzger thinks it was a weekend and early afternoon. On that day MJ, his kids and his security was at the house. Grace wasn't at the house. When they started talking the kids were in the room but later they went outside. Metzger and MJ talked privately. Metzger says the whole visit was 1 hour and 30 minutes and he talked to MJ privately around 20-30 minutes. They talked about medical issues and the stress MJ was under due to the rehearsals and upcoming tour. MJ did not mention seeing another doctor.

    MJ was lucid. He was excited and was talking about creative things. Metzger says he showed both excitement and fear. His fear was about not doing a good job with 50 shows. MJ believed he was up to the task but he was fearful about staying healty. They talked about nutrition and hydration. MJ was doing well with chronic back issues. Metzger says MJ was also under stress due to his sleep disorder.

    MJ was lucid, was exited, talking about creative things, he was in a state of exitement and fear. Fear was about not doing a good job with 50 shows, MJ believed he was up to the task, but he was fearful about staying healthy. They talked about nutrition,MJ had chefs for healthy food, hydration, MJ was doing well with his chronic back issues, he was also under stress due to his profound sleep disorder.

    Metzger says sleep has been an issue for 15 -20 years for MJ especially during touring. Metzger says he traveled with MJ on tour.

    On April 18 2009 MJ asked for "juice" intravenous sleep medication because MJ didn't believe any oral medication would be helpful. Metzger says MJ didn't mention any drugs by name.

    Metzger says from experience he knows previous oral medications doesn't work. Metzger has tried Xanax, Tylenol PM before. In April 2011 he gave MJ klonapim and trazadone to try but not to be used together. He asked MJ to call him and tell him which one worked. Metzger did not speak to MJ after that day.

    Chernoff asks who is Randy Rosen. Metzger says he works with him for pain management issues. Chernoff asks what kind of pain MJ was suffering from. Metzger answers chronic back sprain due to overworking and a couple of injuries. Metzger says he doesn't know Rosen's speciality and the question about what kind of medication given at Rosen's clinic is sustained.

    Metzger says he also presumed MJ would see Klein for his vitiligo and some minor procedures.

    MJ mentioned Metzger that he needed a doctor in London. Metzger says MJ was concerned about hydration, sleep issus and injuries and wanted a doctor with him.

    Cross by Walgren

    Walgren asks about IV treatment. Mezger says he told MJ it was dangerous and it should not be done outside of a hospital.

    Walgren asks if any amount of money would make Metzger to give MJ IV drugs. Metzger says no.

    Chernoff redirect

    Chernoff asks if Metzger told MJ IV sleep medication would be dangerous. Metzger says he told MJ anything IV would be dangerous. Metzger is not sure if MJ asked him for an anesthetic, MJ said "sleep medication".

    Cherilyn Lee

    Direct by Chernoff

    Lee is a nurse practioner that focuses on holistic nutrion. As a nurse practioner she has been doing this on and off for 15 to 20 years and has worked with athletes and entertainers.

    As a nurse practioner she can write prescriptions but she choose not to. She says she doesn't like what medicines does to people, she prefer natural treatments.

    On January 2009 she received a call from FM, who is the son of her friend. FM told her MJ's kids had a cold and MJ wanted her to come and see the kids. While she was looking to the kids, MJ talked with her and asked her what she does. MJ told her he felt a little tired. Lee said that she can do some blood tests on him and try to help him with nutrition.

    Lee went the next day and did a physical test on MJ. She draw blood for lab tests and asked him questions to determine what caused his fatique. MJ didn't mention his sleep problems on that day. He just said he had difficulty to fall asleep. Lee says MJ was drinking "red bull" (an energy drink) and she felt red bull might be the cause. She told MJ about red bull and MJ said "whatever you tell me to do, I will stop".

    Chernoff asks if MJ seemed fatigued. Lee says no. Lee also says MJ told him that he thought he could be anemic. Overall Lee thought MJ was a healthy and loving person.

    Lee gave him nutritional smoothies with protein, B12 shots, myers coctail and vitamin C IV. Lee says she did blood test before she started to gove MJ IV and they were normal.

    Lee goes over the dates she saw MJ and what she gave him. She saw MJ after he came from London and he told her he was tired. At the end of March MJ asked her if she would go to London with him.

    On April 12 easter Sunday. Lee visited MJ. MJ told her he had a sleep problem and nothing she gave him was working. Lee offered to do a sleep study in his home and MJ said he didn't have time for that.

    MJ wanted her to see he couldn't sleep and asked her to stay a night and watch him to sleep. Lee agreed. MJ had "sleepy tea" (a herbal tea), had myers cocktail and Vitamin C IV. The catheter was on his hand because MJ had very small veins. Michael had also joked that he had "squiggly veins". Other than being small he had no problems with his veins. Lee watched him to sleep for 5 hours. MJ waked up around 3 AM.



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    andeli
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    Re: Народът срещу Д- р Конрад Мъри - 24. 10. 2011 - Ден 16

    Писане by andeli on Пет Окт 28, 2011 5:17 pm













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